Managing a chronic condition like psoriasis (PsO) or psoriatic arthritis (PsA) comes with challenges. But for those in the LGBTQ+ community, there can be additional concerns, including finding supportive and understanding health care providers.
Michael Mattes, who lives in Los Angeles and works in digital marketing, has been managing guttate psoriasis and mild PsA in his hands for years. He shares his experiences with treatment, navigating the health care system, and the importance of finding the right doctor.
Finding the Right Care for PsO and PsA
When Michael was first diagnosed, he tried methotrexate (MTX), but it wasn’t the right fit for him. Eventually, he started taking a biologic, which he has been on since 2010. Like many patients, he faced insurance barriers initially, but his treatment was approved thanks to his dermatologist’s advocacy. “I’m really thankful for my dermatologist, who fought to get my insurance to cover it,” he says.
One of the biggest lessons Michael has learned is the importance of seeing the right type of dermatologist. “There are different kinds of dermatologists,” he explains. “Some focus more on cosmetic procedures, while others specialize in medical dermatology. I first went to a dermatologist who didn’t know how to treat psoriasis—it was more of a cosmetic practice. I later found a medical dermatologist who understood my condition and recommended the right treatment.”
LGBTQ+ Experiences in Health Care
For Michael, being part of the LGBTQ+ community has not hindered his health care journey. “I’ve been fortunate—my being gay has never been an issue with my providers,” he says. When he switched insurance from a Preferred Provider Organization (PPO) to Kaiser Permanente, he was relieved to feel supported by his new health care team. “If anything, I’ve been treated with respect, and it’s never been a big deal.”
However, he acknowledges that not all LGBTQ+ patients have the same experience.
His advice? “If you ever feel like a doctor isn’t treating you respectfully or taking your concerns seriously, that’s on them—not on you. You don’t have to stay with a provider who makes you uncomfortable. If you have a network of people, ask for recommendations. Keep looking until you find a provider who will advocate for you.”
Understanding Triggers and Managing Flares
Like many people with psoriasis, Michael has learned to recognize his triggers. “Stress can cause minor flare-ups, but for me, strep throat has been a big trigger,” he shares. “Once, I stayed clear for about four years, but then I got strep throat and had a flare two weeks later.”
His doctor prescribed a short course of antibiotics and recommended light therapy. He underwent stand-up light treatments to help manage his psoriasis, which was similar to a quick session in a tanning bed. The therapy helped clear up his skin. Through his experiences, he also discovered the importance of addressing underlying infections early to prevent more significant flare-ups.
Tips for LGBTQ+ Patients Managing Psoriasis or PsA
Michael’s journey highlights the importance of self-advocacy and finding the proper support. Here are some key takeaways for other LGBTQ+ individuals navigating psoriasis, PsA, and health care:
- Find a medical dermatologist. If your provider seems unfamiliar with psoriasis or PsA treatment, seek a second opinion from a dermatologist specializing in these conditions.
- Advocate for your treatment. If your insurance denies coverage, ask your doctor to help appeal the decision. Many treatments get approved after a doctor submits additional information.
- Listen to your body. Track your triggers, whether they’re stress, infections, or something else, and talk to your doctor about how to manage them.
- Choose a supportive provider. If you feel uncomfortable or dismissed by your doctor, find one who respects you and your health concerns. You deserve quality care.
- Lean on your community. If you don’t know where to start, connect with LGBTQ+ health organizations or psoriasis advocacy groups for recommendations and support.
Michael’s story reminds us that while psoriasis and PsA can be challenging, having the right doctor and a strong support system can make all the difference. No one should feel alone in their health journey, and every patient deserves care that is both effective and affirming.
The Psoriatic Arthritis Club
The Psoriatic Arthritis Club podcast series delves deep into the ups and downs of living with PsA. Through intimate conversations with fellow patients and insights from leading experts, the series offers valuable information on how to manage symptoms, collaborate with healthcare providers, advocate for better care, and emotionally cope with the disease. Along the way, listeners will also pick up life hacks, tips, and tricks to live better with psoriatic arthritis.
This article was made possible with support from Bristol Myers Squibb.
